Organizational Culture and Quality of Life in Nursing Homes: A Qualitative Study

疗养院的组织文化和生活质量：定性研究

• 批准号: 7083209
• 负责人: Miriam Ryvicker
• 金额: $ 3.18万
• 依托单位: NEW YORK UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-05-01 至 2007-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7083209
• 关键词: administrative personnel; behavioral /social science research tag; caregivers; clinical research; conflict; culture; emotional dependency; ethics; health care personnel performance; health care policy; human subject; nursing administration; nursing care evaluation; nursing care quality; nursing homes; nursing personnel; outcomes research; patient care personnel attitude; patient care personnel relations; predoctoral investigator; quality of life; racial /ethnic difference; social support network

DESCRIPTION (provided by the applicant): This dissertation examines the effects of organizational culture on quality of life in two nursing homes. Previous ethnographic studies of nursing homes suggest that the bureaucratic regulations meant to improve quality of care lead to an emphasis on organizational efficiency that conflicts with an ethic of caring. This dissertation re-examines this idea by analyzing how different organizational cultures surrounding bureaucratic regulation affect caregivers' abilities to customize care to residents' individual needs. I conduct ethnographic research in two well-regarded nursing homes that are similar in structural characteristics, but vary in organizational culture, particularly in their approaches to bureaucratic procedure. Therefore, this study asks: How do different organizational cultures shape the formation of a caring environment in nursing homes? Previous assessments of quality of life in nursing homes have used brief observation as a source of data, alongside patient surveys. The comparative ethnographic design of the proposed project deepens the analysis of quality of life by providing a detailed, long-term account of the organizational processes that produce different outcomes in quality of life surveys. Ethnography allows me to examine how caregiving relationships change over time in response to their surrounding circumstances. Out of this approach I develop analytic categories for assessing the degree to which caregivers attend to the emotional needs of residents. The long-term goal of this study is to develop tools for analyzing the effects of different organizational structures and cultures on quality of life in nursing homes and other long-term care facilities. As emphasized in the goals of the Agency for Healthcare Research and Quality, organizational efficiency is a necessary aim for improving overall quality of care in health care facilities such as nursing homes. This study seeks to improve our understanding of how health care organizations can maintain a certain level of efficiency, while promoting practices that respond to patients' social, emotional, and spiritual needs. Therefore, this dissertation advances AHRQ's interests in developing measures of health care quality, improving efficiency in health services, and promoting a patient-centered approach to care.

描述（由申请人提供）：本论文探讨组织文化对两间疗养院生活品质的影响。先前对养老院的人种学研究表明，旨在提高护理质量的官僚法规导致了对组织效率的强调，这与护理伦理相冲突。本文通过分析围绕官僚主义监管的不同组织文化如何影响照顾者根据居民个人需求定制护理的能力，重新审视了这一观点。我在两家声誉良好的养老院进行人种学研究，这两家养老院在结构特征上相似，但在组织文化上有所不同，尤其是在官僚程序的方法上。因此，本研究提出的问题是：不同的组织文化如何塑造养老院关怀环境的形成？以前对养老院生活质量的评估使用了简短的观察作为数据来源，